Going to the doctor in the "Golden Era"?

[kyboots]

Wow! This has certainly been an interesting thread. Medicine in the Golden age was primarily house calls because nothing more could be done. These doctors could deliver babies, dispense some medication, but they were very limited in doing anything else.Treatment for blood pressure prior to 1950 was simply "go to bed". Drugs to treat it really didn't develop until the late 50s. Prior to this time blood pressure took many years from you. In 1900 the average life expectancy in the United States was 46 and the #1 cause of death was pneumonia. As medicine became more sophisticated and surgeries could be performed, doctors became more associated with hospitals. Still in 1930 an appendectomy could be a frightening and major, complicating surgery. It was not until the late 1960s that hospitals actually built intensive care units; now a standard in every facility. Blue Cross Blue Shield WAS actually developed by a group of surgeons years ago in an attempt to get paid,nothing secretive about that. Later it became much bigger than the surgeons and set a standard by which most fees were set. At one time these companies ( who were the only game in town then ) could determine whether a hospital could have a new mortgage and expand or not. They would pay the hospital with the mortgage more than one without. Of course these inequities are long gone but it is true that most all fees are still set and determined for a hospital and for a doctor by the insurance carriers and Medicare. Medicare was not created until 1965 and provided welcome relief for those over 65 without the ability to pay. However, In the last 15 years Medicare has ruined the doctor- physician relationship in this country with out a doubt, but That is for another day. For what most of us take as just standard was not here when your grandparents were young. Medicine has advanced dramatically and with it, there had been growing pains but with growth will come more. Medical knowledge doubles every 4 years and with that comes unbelievable advances and the need for ethical decisions. I have sat on our hospitals very large Ethics Committee for over 15 years, and the decisions keep getting harder. There is no cure for cancer, or cure for AIDS that we keep hidden, but there are people who believe this! Sitting on these committees we do what we think best for the patient. It is always for the patient and no one else. Patient's are not to be lied to and if they ask are to be informed. That's the way it has always been. For those of us in the United States, you have the right to go elsewhere and get opinions. Anyone who is unhappy or has concerns always has that right. For the record: I don't compromise in the way I treat patients. I tell them what I believe to be best. Anything less is unacceptable and not related to this thread. Needless to say longevity in the golden era was most related to good genes.

 

[amador]

I take a shower daily because I feel that I have somehow comporomised myself, metaphorical shower.
During my interview for medical school I was asked about my understanding of the practice of medicine. As I recall i said something along the following.
In the past a man may have developed a life threatening disease. Medicine would answer that there was a procedure or a treatment that might cure him but he would have to sell the family farm for the possibility of a cure. If he sold the family farm then his family would not have a future as farmers.and he may not survive. If he let his disease run its natural course he would leave behind a widow and orphans. The second option would offer his family a future as had been handed down in the family. Big decision and our patient would probably opt to keep the farm in the family. In our modern delivery of medicine there is now someone else who will pay for the medical attention, the farm is safe so there is no question that an attempt will be made to save the patient no matter what the cost, even if it exceeds the value of several farms. The admissions panel seemed to accept this analysis no follow up questions. The next question was about what type of doctor I wanted to be.

 

[Stanley Doble]

There are no cures that are kept hidden now that we have the Internet. My experience is that medicine in general is a lot less effective than people think. Watch TV and movies and get the impression a doctor can cure anything in two minutes. Not true. When you get right down to it they can't do very much at all. I prefer to believe this, rather than that they are withholding some cure that could have saved my parents' lives and saved me a lot of pain and misery.

This may be the reason a lot of people think the medical trust is suppressing cures. If we have been led to believe medicine can cure anything, then when we get sick they get all shifty and start making excuses, I can see where innocent people could jump to the conclusion they are hiding something. But if they are it is not the cure, it is the lack of a cure. Such people just aren't cynical enough. I'm not myself. I think I am, but every so often something comes along that proves things are way worst than I thought.

What I resent is the way doctors lie for the fun of it. If I told you some of the lies they told me, you wouldn't believe it. Looking back, I can hardly believe it myself. But in my younger days I looked up to doctors and trusted them.

If I hadn't wised up and had continued to listen to them I would undoubtedly be dead now. Today I will listen to a doctor but won't take his advice unless I can confirm it by at least 3 independent sources. If I can't do that, I will ignore the advice or do the opposite. In the past, if I had done this I would have been way better off.

 

[amador]

I don't know if liying is fun, haven't tried it since my mother told me not to do it. I don't think she would lie about something like that no matter how much fun she thought it would be. Thanks.

 

[Stanley Doble]

If you don't lie to your patients and if you care whether they live or die that puts you ahead of the doctors I meet around here. I congratulate you.

 

[Stanley Doble]

The obstacles i have to overcome to be able to pactice medicine and for the privilage of helping someone are formidable. Compromising some of my ideals for the benefit of my patient seems to be the norm. Some of my patients do not want to hear the truth, some have actually complained that i have revealed reality, they would rather take a pill. The truth doesn't set men free, it just annoys them. I wear a Fedora, 'nuff said.

The Bible tells us the truth will set you free. It doesn't say it will make you happy. I would rather be pissed off and know the truth. Let me deal with it. Maybe some of your patients feel the same way once they calm down.

It is possible to ignore reality. But it isn't possible to ignore the consequences of ignoring reality.

Will also say, if you were my doctor and I caught you in a lie, even the most innocent and well meaning lie, I would never trust a single thing you said about anything, ever. Because you might be lying to me again with the best of intentions.

You would probably never know it. I can lie too, and pretend to take bullshit serious. After all it's not so easy to get a doctor these days, no use pissing them off by calling them on their lies. Just throw the prescription away once you get out of sight.

I'm sorry if this sounds harsh. It's not your fault and I have nothing against you. Just some old baggage from the past.

 

[amador]

One observation can be made. In the past Doctors were held in high esteem and their pronouncements held as true wisdom. Now it seems that the pedestal has been removed and the Doctor does have feet of clay. Therefore your health is now your responsibility and you seek the assistance of a Doctor to attend to it.
Just like your car. You may drive recklessly and disreguard maintenance. Once you have an accident or breakdown, you seek the assistnace of a repair shop or a mechanic. They will advise you to drive carefully and change your oil regularly. It is up to you to do so. Pay me now or pay me later.

 

[The Wiser Hatter]

NUTEX Radium Condoms (ca. 1940s)

 

[amador]

Goes to show that glow in the dark toys have been popular in the past. That way you can see me coming. Sorry couldn't resist. I will do penance. Say some Hail Maries, and do a couple of laps around the beads. Thank you.

 

[docneg]

Dad's been freaking out about my blood-pressure.


I asked him why he did it the old-fashioned way and didn't use a modern digital monitor.

In his own words: "Gravity never lies" and "the mercury is much more accurate". The golden-era blood-pressure monitors with the hand-pumps and the mercury guages, while they might take a bit longer to operate, give much more accurate readings than modern digital ones. That's why he still keeps it in his office.

He's absolutely right. And that's why I still use one also.

 

[Jaguar66]

There is no cure for cancer, or cure for AIDS that we keep hidden, but there are people who believe this! .

Much of what you speak is accurate, there is no cure for every cancer, or every case of AIDS. However, I know you must be aware of the many cures that do happen. I know personally of a man who had colon cancer, with metastasis to the liver who is alive and well today, cancer free, 10 years later. I know personally a lady who lay in the ICU, on a respirator, and had a respiratory arrest with PCP pneumonia, who is alive and free of detectable virus 10 years later. These people are living normal lives.

The practice of medicine today, while much different today, is still an honorable way to ethically serve to aid ones fellow man/woman/child. As stated in this Oath.

I swear to fulfill, to the best of my ability and judgment, this covenant:
I will respect the hard-won scientific gains of those physicians in whose steps I walk, and gladly share such knowledge as is mine with those who are to follow.

I will apply, for the benefit of the sick, all measures [that] are required, avoiding those twin traps of overtreatment and therapeutic nihilism.

I will remember that there is art to medicine as well as science, and that warmth, sympathy, and understanding may outweigh the surgeon's knife or the chemist's drug.

I will not be ashamed to say "I know not", nor will I fail to call in my colleagues when the skills of another are needed for a patient's recovery.

I will respect the privacy of my patients, for their problems are not disclosed to me that the world may know. Most especially must I tread with care in matters of life and death. If it is given to me to save a life, all thanks. But it may also be within my power to take a life; this awesome responsibility must be faced with great humbleness and awareness of my own frailty. Above all, I must not play at God.

I will remember that I do not treat a fever chart, a cancerous growth, but a sick human being, whose illness may affect the person's family and economic stability. My responsibility includes these related problems, if I am to care adequately for the sick.

I will prevent disease whenever I can, for prevention is preferable to cure.

I will remember that I remain a member of society with special obligations to all my fellow human beings, those sound of mind and body as well as the infirm.
If I do not violate this oath, may I enjoy life and art, respected while I live and remembered with affection thereafter. May I always act so as to preserve the finest traditions of my calling and may I long experience the joy of healing those who seek my help.

 

[kyboots]

I am not aware of any cure (that we keep hidden)

 

[sheeplady]

I had an experience the other day that kind of illustrates the frustration that some people have with the healthcare system. I wanted to get a vaccine titer done because several of my vaccines were questionable (timing and number) according to my physician. I'm very serious about herd immunity and I don't want to spread things to people who cannot have the vaccines.

I was told that my insurance would not pay for a titer unless I was sick. So in other words, I have to come down with something that apparently I could be vaccinated for, compromise all sorts of people's health (including my own), before I can get a titer? What good is that going to do at that point- show that I (obviously) don't have immunity?

 

[kyboots]

I had an experience the other day that kind of illustrates the frustration that some people have with the healthcare system. I wanted to get a vaccine titer done because several of my vaccines were questionable (timing and number) according to my physician. I'm very serious about herd immunity and I don't want to spread things to people who cannot have the vaccines.

I was told that my insurance would not pay for a titer unless I was sick. So in other words, I have to come down with something that apparently I could be vaccinated for, compromise all sorts of people's health (including my own), before I can get a titer? What good is that going to do at that point- show that I (obviously) don't have immunity?

I honestly share your frustration as do most physicians. Most insurers simply have the" not broke" idea. Preventive care is not the way health care has ever been. {We spend 90 % of our health care dollars on our last six months of life! Good grief Charlie Brown how stupid!} In your situation, It would be cheaper just to repeat the vaccines and not do the titers; and most insurers then would pay for the vaccines. If we got people to quit smoking and exercise we would save more lives than we do now. The government is just now starting to look at this with the "patient centered medical home" ideas that are coming. Old ideas new name.This actually begins an attempt for preventive care, but also assigns you to a specific cluster of health care providers ( may be good might be very bad), we just have to wait and see.

 

[amador]

I have insulted several patients by saying that I have mounted a one man campaign to destroy the medical industry and the insurance industry in this country. I am going to get everyone to stop smoking and to eat less. One patient at a time.

We will be closing down medical and nursing schools, demolishing hospitals and the insurance industry will go bankrupt.
I have a long way to go.